Elevated pulmonary artery pressure is a risk factor for primary graft dysfunction following lung transplantation for idiopathic pulmonary fibrosis

Adam Fang, Sean Studer, Steven M. Kawut, Vivek N. Ahya, James Lee, Keith Wille, Vibha Lama, Lorraine Ware, Jonathan Orens, Ann Weinacker, Scott M. Palmer, Maria Crespo, David J. Lederer, Clifford S. Deutschman, Benjamin A. Kohl, Scarlett Bellamy, Ejigayehu Demissie, Jason D. Christie

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Idiopathic pulmonary fibrosis(IPF)is often associated with elevations in pulmonary artery pressures. Although primary pulmonary arterial hypertension (PAH) has been associated with primary graft dysfunction (PGD), the role of secondary PAH in mediating PGD risk in patients with IPF is incompletely understood. The purpose of this study was to evaluate the relationship between mean pulmonary artery pressure(mPAP)and PGD among patients with IPF. Methods: We performed a multicenter prospective cohort study of 126 lung transplant procedures performed for IPF between March 2002 and August 2007. The primary outcome was grade 3 PGD at 72 h after lung transplant. The mPAP was measured as the initial reading following insertion of the right-sided heart catheter during lung transplant. Multivariable logistic regression was used to adjust for confounding variables. Results: The mPAP for patients with PGD was 38.5 ± 16.3 mm Hg vs 29.6 ± 11.5 mm Hg for patients without PGD (mean difference, 8.9 mm Hg [95% CI, 3.6-14.2]; P =.001). The increase in odds of PGD associated with each 10-mm Hg increase in mPAP was 1.64 (95% CI, 1.18-2.26; P =.003). In multivariable models, this relationship was independent of confounding by other clinical variables, although the use of cardiopulmonary bypass partially attenuated the relationship. Conclusions: Higher mPAP in patients with IPF is associated with the development of PGD.

Original languageEnglish (US)
Pages (from-to)782-787
Number of pages6
JournalCHEST
Volume139
Issue number4
DOIs
StatePublished - Apr 2011

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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